Comparison of fore- and midfoot angles using 3DCT in standard weightbearing and sesamoid view position in feet with hallux valgus

Aims: To evaluate how fore- and midfoot coronal plane alignment differs in feet with hallux valgus (HV), using 3DCT when measured in standard weightbearing (SWB) versus sesamoid view (SV) position, and to determine whether first metatarsophalangeal (MTP) dorsiflexion affects the relationship betwee...

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Main Authors: Martin Tripon, Matthieu Lalevee, Floris van Rooij, Chinyelum Agu, Mo Saffarini, Philippe Beaudet
Format: Article
Language:English
Published: The British Editorial Society of Bone & Joint Surgery 2025-02-01
Series:Bone & Joint Research
Subjects:
Online Access:https://online.boneandjoint.org.uk/doi/epdf/10.1302/2046-3758.142.BJR-2024-0172.R2
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author Martin Tripon
Matthieu Lalevee
Floris van Rooij
Chinyelum Agu
Mo Saffarini
Philippe Beaudet
author_facet Martin Tripon
Matthieu Lalevee
Floris van Rooij
Chinyelum Agu
Mo Saffarini
Philippe Beaudet
author_sort Martin Tripon
collection DOAJ
description Aims: To evaluate how fore- and midfoot coronal plane alignment differs in feet with hallux valgus (HV), using 3DCT when measured in standard weightbearing (SWB) versus sesamoid view (SV) position, and to determine whether first metatarsophalangeal (MTP) dorsiflexion affects the relationship between the first metatarsal (M1) head and the sesamoid bones. Methods: A consecutive series of 34 feet that underwent 3DCT in SWB and SV positions for symptomatic HV was assessed, of which four feet were excluded for distorted or incomplete images. Two foot and ankle clinicians independently digitized a series of points, and measured a series of angles according to a pre-defined protocol. Measurements include navicular pronation angle, M1 head (Saltzman angle), and metatarsosesamoid rotation angle (MSRA). Results: The mean age of the 30 patients was 57.5 years (SD 13.4). The mean navicular pronation angle was significantly smaller in the SV position (9.6° (SD 4.4°)) compared to the SWB position (16.4° (SD 5.8°); p < 0.001). There was a difference in MSRA between the SWB and SV positions, revealing an increase in MSRA in 22 patients, while there was a decrease in eight patients. In patients where the MSRA increased, the mean Saltzman angle was 2.5° (SD 5.7°) lower in the SV position versus the SWB position, while in patients where MSRA decreased, the mean Saltzman angle was 3.4° (SD 3.6°) greater in the SV position versus the SWB position. Conclusion: MTP dorsiflexion causes supination of the navicular, while other first ray parameters remain unchanged, and has a greater influence on the M1 head coronal alignment than on the sesamoids. MTP dorsiflexion induces axial rotations of M1, which vary in direction and magnitude from one patient to another. Cite this article: Bone Joint Res 2025;14(2):69–76.
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spelling doaj-art-72fde85ccecd4c4b9c2658cbf9720a212025-08-20T02:02:01ZengThe British Editorial Society of Bone & Joint SurgeryBone & Joint Research2046-37582025-02-01142697610.1302/2046-3758.142.BJR-2024-0172.R2Comparison of fore- and midfoot angles using 3DCT in standard weightbearing and sesamoid view position in feet with hallux valgusMartin Tripon0https://orcid.org/0000-0001-6801-1740Matthieu Lalevee1https://orcid.org/0000-0001-5058-8867Floris van Rooij2https://orcid.org/0000-0002-3513-0599Chinyelum Agu3https://orcid.org/0009-0000-5351-5268Mo Saffarini4https://orcid.org/0000-0002-9656-987XPhilippe Beaudet5https://orcid.org/0009-0002-1847-4952Department of Orthopedic Surgery, Rouen University Hospital, Rouen, FranceDepartment of Orthopedic Surgery, Rouen University Hospital, Rouen, FranceReSurg SA, Nyon, SwitzerlandReSurg SA, Nyon, SwitzerlandReSurg SA, Nyon, SwitzerlandClinique Trénel, Sainte-Colombe, FranceAims: To evaluate how fore- and midfoot coronal plane alignment differs in feet with hallux valgus (HV), using 3DCT when measured in standard weightbearing (SWB) versus sesamoid view (SV) position, and to determine whether first metatarsophalangeal (MTP) dorsiflexion affects the relationship between the first metatarsal (M1) head and the sesamoid bones. Methods: A consecutive series of 34 feet that underwent 3DCT in SWB and SV positions for symptomatic HV was assessed, of which four feet were excluded for distorted or incomplete images. Two foot and ankle clinicians independently digitized a series of points, and measured a series of angles according to a pre-defined protocol. Measurements include navicular pronation angle, M1 head (Saltzman angle), and metatarsosesamoid rotation angle (MSRA). Results: The mean age of the 30 patients was 57.5 years (SD 13.4). The mean navicular pronation angle was significantly smaller in the SV position (9.6° (SD 4.4°)) compared to the SWB position (16.4° (SD 5.8°); p < 0.001). There was a difference in MSRA between the SWB and SV positions, revealing an increase in MSRA in 22 patients, while there was a decrease in eight patients. In patients where the MSRA increased, the mean Saltzman angle was 2.5° (SD 5.7°) lower in the SV position versus the SWB position, while in patients where MSRA decreased, the mean Saltzman angle was 3.4° (SD 3.6°) greater in the SV position versus the SWB position. Conclusion: MTP dorsiflexion causes supination of the navicular, while other first ray parameters remain unchanged, and has a greater influence on the M1 head coronal alignment than on the sesamoids. MTP dorsiflexion induces axial rotations of M1, which vary in direction and magnitude from one patient to another. Cite this article: Bone Joint Res 2025;14(2):69–76.https://online.boneandjoint.org.uk/doi/epdf/10.1302/2046-3758.142.BJR-2024-0172.R2hallux valgusctsesamoid viewtangential viewstandard weightbearinghallux valgus (hv)midfootpronationdorsiflexionsupinationcoronal alignmentclinicianssesamoid bonesanklefirst metatarsal
spellingShingle Martin Tripon
Matthieu Lalevee
Floris van Rooij
Chinyelum Agu
Mo Saffarini
Philippe Beaudet
Comparison of fore- and midfoot angles using 3DCT in standard weightbearing and sesamoid view position in feet with hallux valgus
Bone & Joint Research
hallux valgus
ct
sesamoid view
tangential view
standard weightbearing
hallux valgus (hv)
midfoot
pronation
dorsiflexion
supination
coronal alignment
clinicians
sesamoid bones
ankle
first metatarsal
title Comparison of fore- and midfoot angles using 3DCT in standard weightbearing and sesamoid view position in feet with hallux valgus
title_full Comparison of fore- and midfoot angles using 3DCT in standard weightbearing and sesamoid view position in feet with hallux valgus
title_fullStr Comparison of fore- and midfoot angles using 3DCT in standard weightbearing and sesamoid view position in feet with hallux valgus
title_full_unstemmed Comparison of fore- and midfoot angles using 3DCT in standard weightbearing and sesamoid view position in feet with hallux valgus
title_short Comparison of fore- and midfoot angles using 3DCT in standard weightbearing and sesamoid view position in feet with hallux valgus
title_sort comparison of fore and midfoot angles using 3dct in standard weightbearing and sesamoid view position in feet with hallux valgus
topic hallux valgus
ct
sesamoid view
tangential view
standard weightbearing
hallux valgus (hv)
midfoot
pronation
dorsiflexion
supination
coronal alignment
clinicians
sesamoid bones
ankle
first metatarsal
url https://online.boneandjoint.org.uk/doi/epdf/10.1302/2046-3758.142.BJR-2024-0172.R2
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